Prescription Painkiller Overdoses

About 18 women die every day of a prescription painkiller overdose in the US, more than 6,600 deaths in 2010. Prescription painkiller overdoses are an under-recognized and growing problem for women.

Although men are still more likely to die of prescription painkiller overdoses (more than 10,000 deaths in 2010), the gap between men and women is closing. Deaths from prescription painkiller overdose among women have risen more sharply than among men; since 1999 the percentage increase in deaths was more than 400% among women compared to 265% in men. This rise relates closely to increased prescribing of these drugs during the past decade. Health care providers can help improve the way painkillers are prescribed while making sure women have access to safe, effective pain treatment.

When prescribing painkillers, health care providers can

Recognize that women are at risk of prescription painkiller overdose.

Follow guidelines for responsible prescribing, including screening and monitoring for substance abuse and mental health problems.

Use prescription drug monitoring programs to identify patients who may be improperly obtaining or using prescription painkillers and other drugs.

Prescription painkiller overdose deaths are a growing problem among women.

Federal government is

Educating health care providers and the public about prescription drug misuse, abuse, suicide, and overdose, and the risks for women.

Developing and evaluating programs and policies that prevent and treat prescription drug abuse and overdose, while making sure patients have access to safe, effective pain treatment.

Working to improve access to mental health and substance abuse treatment through implementation of the Affordable Care Act.

Health care providers can

Recognize that women can be at risk of prescription drug overdose.

Discuss pain treatment options, including ones that do not involve prescription drugs.

Discuss the risks and benefits of taking prescription painkillers, especially during pregnancy. This includes when painkillers are taken for chronic conditions.

Follow guidelines for responsible painkiller prescribing, including:

Screening and monitoring for substance abuse and mental health problems.

Prescribing only the quantity needed based on appropriate pain diagnosis.

Using patient-provider agreements combined with urine drug tests for people using prescription painkillers long term.

Teaching patients how to safely use, store, and dispose of drugs.

Avoiding combinations of prescription painkillers and benzodiazepines (such as Xanax and Valium) unless there is a specific medical indication.

Talk with pregnant women who are dependent on prescription painkillers about treatment options, such as opioid agonist therapy.

Use prescription drug monitoring programs (PDMPs)—electronic databases that track all controlled substance prescriptions in the state—to identify patients who may be improperly using prescription painkillers and other drugs.

States can

Take steps to improve PDMPs, such as real time data reporting and access, integration with electronic health records, proactive unsolicited reporting, incentives for provider use, and interoperability with other states.

Identify improper prescribing of painkillers and other prescription drugs by using PDMPs and other data.